IMPRESSIONS IN FPD

SNEHKIRAN RAGHUVANSHI
JR2
 INTRODUCTION

 To obtain an impression is the first step necessary for the

indirect fabrication of a prosthesis.

 Well-fitting indirect restorations can only be made if

there are accurate casts of the oral tissues available, made
from high quality impressions.

 A good quality impression is only obtained when we

have a thorough knowledge of materials, their properties,
and techniques for their best manipulation.
 DEFINITIONS

 IMPRESSION : A negative likeliness or copy in reverse

of the surface of an object; an imprint of the teeth and
adjacent structures for use in dentistry –
G.P.T-8

 IMPRESSION TRAY : A receptacle into which suitable

impression material is placed to make a negative
likeliness (or) a device that is used to carry, confine, and
control impression material while making impression–
G.P.T-8
 IMPRESSION MATERIAL : Any substance or
combination of substances used for making an impression
or negative reproduction. – G.P.T 8

 IMPRESSION TECHNIQUE : A method and manner

used in making a negative likeness. – G.P.T 8
 IMPRESSION TRAYS

1. STOCK TRAYS
2. CUSTOM TRAYS

CUSTOM TRAYS

•Better for elastomers than hydrocolloids.

•Reduces bulk

•Bulky impression has lower surface area to volume.

 TYPES OF CUSTOM TRAYS

 Auto polymersing resin

 Photo polymerised resin

 Thermoplastic
Design for spacer
HISTORY
• Philip Pfaff-1756
• First described taking impression with softened wax

• Christophe Francois Delabarre-1820

• Introduced the metal impression tray

• Chapin Haris-1853
• First used Plaster of Paris for making impressions.

• Charles Stent-1857
• Introduced the first impression compound
• Sears-1937

• First used agar hydrocolloids for recording crown

impressions.

• United States-1945

• Introduced alginate during World War II.

• SL Pearson-1955

• Developed synthetic rubber base impression materials

• Polysulfide- Late 1950’S

• First developed as an industrial sealant.

• Condensation Silicone- Early 1960’s

• Addition Silicone-1970’s

• Polyether- Late 1970’s

• Polyether Urethane Dimethacrylate - Late 1980’s

IMPRESSION MATERIALS USED IN
F.P.D
 Alginate impression should be poured within 10
minutes after removal from mouth and should not be
wrapped in a moist paper towel as seems to be a
common practice.

 The impression absorbs water from the wet

towel/ cotton and can distort before pouring.
 “Perhaps no procedure done on a routine basis in
dentistry contains more uncertainty and yet
holds more importance for outcome than that of
dental impression”

A review of contemporary impression materials and

techniques:Terry E. Donovan;Dent Clin N Am 48 (2004) 445–
470
 PROPERTIES OF AN IDEAL
IMPRESSION MATERIAL

 Accuracy
 Elastic recovery
 Dimensional stability
 Flow and flexibility
 Workability
 Hydrophilicity
 Shelf life
 Patient comfort
 Economic factors
 ACCURACY

 Ability to reproduce fine detail

 Dimensional accuracy

 ADA 19 – 25 µ / less

PVS is best as compared to alginate , although it can meet 25

micron limit
Int J Prosthodont 2000;13:214
 ELASTIC RECOVERY

 NO impression material has 100% elastic recovery.

 Greater the depth of undercut, greater the distortion.
 Occurs almost instantaneously as the impression is
removed from mouth.

PVS impression material have the best

elastic recovery at over 99%
J Prosthet Dent 1991;66: 292- 96
 DIMENSIONAL STABILITY

 IDEAL DIMENSIONAL STABILITY - PVS

Pouring time
MATERIAL POURING TIME
PVS Immediately, hours, weeks
hydrocolloids 10 min
Polysulfides, condensation silicone 30 min
polyether 1 hour
 FLEXIBILITY

Material flexibility
polyether Most rigid
Addition silicone Reasonably stiff
Reversible hydrocolloid Least rigid
 WORKABILITY

 Automix devices improved workability

When making impression of multiple prepared teeth, clinician

may opt to refrigerate the low viscosity material , which increases
working time without sacrificing accuracy.
Int J Prosthodont 1993;6:528- 32
 Material consistency
polysulfide L,M,H
Condensation silicone L,VH
Addition silicone L,M,H,Vh, monophase
Polyether M, monophase
 Disinfection

Polysulfide 2% gluteraldehyde 15- 20 min

silicones 2% gluteraldehyde 15 – 20 min

polyethers Iodophors,phenols 10 min

hydrocolloids spraying 10 min

 Principles of impression material
manipulation
 Uniform bulk
 Adhesion of impression materials to the tray
 Pouring of impression materials
 Viscosity control
 Adequate mixing

A review of contemporary impression materials and

techniques:Terry E. Donovan;Dent Clin N Am 48 (2004)
445–470
 IMPRESSION TECHNIQUES
 Copper band technique

 Reversible hydrocolloid technique

a) Laminate Technique
b) Wet Field Technique

 Elastomeric impression materials

a) Putty wash technique a) Heavy body light body

combination
b) Dual arch technique
b) Single mix
c) The matrix system c) Auto mix
d) Machined mix
 Copper Band or Tube Method
 Used where there is only vague margins on one or two
preparation that are not adequately replicated in the
impression.

 A copper band is selected and annealed by heating on a

flame and quenching in alcohol.
Gingival margin are crimped to adapt to gingival contour
 Evaluating the fit of the copper band

 The circumference of the copper band must be such

that it will fit over the preparation and still project
into the gingival crevice.

 An oversize band should not be used since it will

impinge on the gingival tissues.
Copper band with the final
impression
 Laminate Technique (or) Agar Alginate
Combination Technique

 After injecting the syringe agar on to

the area to be recorded, an impression
tray containing a mix of chilled
alginate that will bond with the
syringe agar is positioned on it.

 The alginate gels by a chemical

reaction, whereas the agar gels by
means of contact with the cool
alginate rather than the water
circulating through the tray.
 Advantages
1) Accurate reproduction of details.
2) Less air bubbles .
3) Water cooled trays are not required.
4) It sets faster than the regular agar technique.
5) Economical and simple.
6) Liquefaction and storage of agar not required.
 Wet field technique

 This is relatively new technique which has become

popular, the areas to be recorded are actually flooded with
warm water.

 Then the syringe material is introduced quickly, liberally

and in bulk to cover the occlusal and/or incisal areas only,
while the syringe material is still liquid, the tray material is
seated.
 The hydraulic pressure of the viscous tray materials
forces the fluid syringe hydrocolloid down into the areas
to be recorded.

 This motion displaces the syringe materials as well as

blood and debris throughout the sulcus.
 Putty wash technique:

Can be done by 3 methods-

1. Use of putty material to fabricate custom tray.

2. Use of relieved putty impression.
3. Simultaneous /squash technique.

A review of contemporary impression materials and

techniques:Terry E. Donovan;Dent Clin N Am 48 (2004) 445–470
Use of putty material to fabricate custom tray
 Relieved putty impression

 Preoperative impression made intra orally.

 Plastic sheet is placed over teeth to prevent material
from entering embrasures.
 From preparation area, impression material is removed
using blade to provide relief.
 Impression is washed / relined using low viscosity
impression material.
 Simultaneous/squash technique

 Stock tray is loaded with putty material and syringe is

injected around the prepared tooth or teeth.

 Tray containing putty material is squashed over the

putty material.

 Its impossible to control what material records the

margin detail of the preparation.
1. Heavy body light body combination

2. Single mix technique

3. Auto mix technique-

(prepackaged cartridges)

4. Machine mixing technique-( pentamix automatic

mixing unit)
 EVALUATING FINAL IMPRESSIONS

 Elastomeric material should be present 0.5 mm beyond

visible finish line.

 Note presence of bur marks, the junction of smooth root

surface, and continuous finish line.

 There should be no shiny smooth areas; if present, they

suggest moisture contamination.
 There must be no voids present, they suggest mixing
problems or contamination.

 There should be no thin areas leaving the finish line

unsupported.

 These areas distort under the weight of the stone.

 There should be no tray show though in any areas of

the impression except at tissue stops.
Close Bite Double Arch Method
 Synonyms : Dual quad tray, double arch , triple arch ,
accu -bite ,closed mouth impression.

Requirements

1. Presence of stops anterior and posterior to the

prepared teeth.
2. Patient must be able to close completely in MIP
3. Rigid tray should be used that does not flex.
 Technique

 Evaluate the fit of the tray in the patients mouth.

 Observe the complete bilateral closure and the patients

comfort
 Making the final impression

 Mix the low viscosity material and

load the syringe , high viscosity
material is used in the tray.

 After the low viscosity material is

syringed the tray is positioned on the
arch.

 Instruct the patient to close the

mouth and observe for the inter
digitation on the opposite arch.
• Instruct the patient to open the mouth remove the tray by
applying equal pressure bilaterally.

• Evaluate the impression

 ADVANTAGES

1. The physical deformation of the mandible is minimal.

2. The shifting of teeth occurring during maximum

intercuspation is captured.

3. Less impression material is needed.

4. Less gagging may occur.

 The matrix impression system
 This system uses three impression materials

Matrix impression material

Tray impression material
Matrix forming material

The matrix impression system for fixed prosthodontics:Gus

J. Livaditis; JPD;volume 79 number 2
Matrix impression system
(Described by Levaditis)
 Slender bur or knife edged rubber
wheel used to enlarge interproximal
embrasures. Black Lines Indicate
sulcular extension .

 Thick red line indicates crest of

gingiva.

 Two black marks point out proximal

contacts that must be relieved.

 Matrix should extend one half to two

thirds of tooth beyond prepared teeth
and close to gingival crest.
low
 COMMON ERRORS
ERROR REASON SOLUTION
1 Inadequate marginal details Inadequate Proper fluid
retraction control
2 Bubbles 1.Air Proper
entrapment manipulation of
2.Inadequate material
retraction Fluid control
3 Marginal tear Removal of Proper
impression manipulation of
before its set material
4 Tray shows through Tray too small Proper selection
of tray
5 Separation of material from Inadequate Perforated trays
the tray retention Tray adhesive
6 Stepped impression(need for Inadequate
occlusal adjustment) syringe material
A clinical evaluation of fixed partial denture impressions: Nachum
Samet; J Prosthet Dent 2005;94:112-7.
 SUMMARY
 A good impression is an exact replica of each
prepared tooth and should include adequate amount of
the unprepared surfaces adjacent to the margin.

 Impression technique and material should be selected

on the basis of biologic factor dictated by the
anatomy and the physiology of the mouth dictated by
the orofacial tissues
 Even though there are innumerable techniques and
procedure for impression making ,it is the responsibility of
the dentist to select the best possible procedure based on
sound knowledge , for achieving the best possible result for
the patient.